European journal of cancer : official journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)
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Exposure to radon in dwellings may cause cancer including paediatric malignancies. Devon and Cornwall have the highest exposure to radon of the counties of England. However, within these counties there is considerable variation in exposure. ⋯ No significant difference in the incidence rate of 106.7 per million child years in the high radon postcode sectors and 121.7 in the low (P = 0.29) was found. When the incidences of individual tumours were examined, a significantly increased rate of neuroblastoma (P = 0.02) and a non-significant increased rate of acute myeloid leukaemia were found in the high exposure postcode sectors. No association between radon exposure and overall rate of childhood malignancy was found.
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The effective radiation doses received by children living in high radon areas are similar to those which have been associated with an excess risk of malignant disease elsewhere. However, the only cancer known to be associated with radon is lung cancer--a disease which is not a condition of childhood. ⋯ The risk to health of high levels of radon in the environment remains uncertain. The United Kingdom Case Control Study of Childhood Cancers, under the chairmanship of Sir Richard Doll, is assessing risk from many factors including measured radon exposure and it is with great interest that we await the results.
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The efficacy of CPT-11 (Campto, irinotecan) given as a single agent has been assessed in three phase II clinical studies of patients with advanced colorectal cancer conducted in Japan, Europe and the U. S. Among a total of 337 evaluable patients treated with CPT-11 in dosage schedules of 100-150 mg/m2 weekly or bi-weekly (Japan, n = 63; U. ⋯ CPT-11, therefore, has significant activity in advanced colorectal cancer with response rates that are reproducible, durable and comparable to those achieved with 5-FU plus folinic acid in the first-line treatment of metastatic disease. Further work is needed to define the optimum dosage schedule for CPT-11 and also to assess fully the utility of CPT-11 in combination with other chemotherapeutic agents. Nevertheless, the activity of CPT-11 in patients refractory to treatment with 5-FU may be considered a significant advance, making it the first effective second-line agent in this setting.
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The EORTC Core Quality of Life questionnaire (EORTC QLQ-C30) is designed to measure cancer patients' physical, psychological and social functions. The questionnaire is composed of multi-item scales and single items. 247 patients completed the EORTC QLQ-C30 before palliative radiotherapy and 181 after palliative radiotherapy. The questionnaire was well accepted with a high completion rate in the present patient population consisting of advanced cancer patients with short life expectancy. ⋯ Excellent criterion validity was found for the emotional functioning scale where it was correlated with GHQ-20. Performance of the questionnaire was improved after the second evaluation as compared with the first. The present study shows that the EORTC QLQ-C30 is found to be practical and valid in measuring quality of life in patients with advanced disease.
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In 1977, Zelen proposed a new design for clinical trials with the aim of increasing recruitment by avoiding some of the problems associated with obtaining informed consent. These 'randomised consent' designs have proved controversial, and have not often been used. ⋯ All identified published cancer treatment trials using a randomised consent design are considered in some detail. Reasons for and against the use of these designs are summarised.